Abstract
The aim of this prospective randomized study was to evaluate the impact of different sharp-edged intraocular lenses (IOLs) (hydrophobic acrylic or silicone) on posterior and anterior lens capsule opacification (PCO and ACO) at 3-year postoperative follow-up. A total of 96 eyes (89 patients) having a standard uncomplicated phacoemulsification procedure for age-related cataract were included in a prospective clinical study: 34 eyes with a 3-piece acrylic hydrophobic (AcrySof, MA3OBA), 32 eyes with a 1-piece acrylic hydrophobic (AcrySof, SA3OAL), and 30 eyes with a 3-piece silicone (CeeOn 911A) IOL. Visual acuity, capsulorrhexis/optic overlapping, ACO and PCO (using EPCO2000 system) were evaluated at 3-year follow-up. Capsulotomies performed by means of neodymium-yttrium-aluminum-garnet (Nd:YAG) laser were recorded. Three years after surgery, the grade of ACO of the capsulorrhexis rim area and the capsule/optic area was significantly greater in the silicone IOL group than in the acrylic IOL groups (P<0.05). During 3 postoperative years, there were no significant differences in the PCO values either in the entire IOL optic area or in the central 3-mm optic zone comparing the groups. Three years after surgery, 9% of eyes with a 3-piece acrylic IOL, 3.1% of eyes with a 1-piece acrylic IOL, and no case in the silicone IOL group had Nd:YAG capsulotomy (P>0.05). The 3-year follow-up after cataract surgery showed no difference in PCO development (EPCO2000) between acrylic hydrophobic and silicone sharp-edged IOLs. However, the need for Nd:YAG laser capsulotomy was higher in the acrylic IOL groups than the silicone IOL group, though the difference was not significant. ACO was greatest in the eyes with 3-piece silicone IOLs.
Highlights
Posterior capsule opacification (PCO) or secondary cataract is a major long-term complication of successful cataract surgery starting from the beginning of extra capsule cataract extraction with intraocular lens (IOL) implantation
Our results showed no significant difference in the PCO values in the entire IOL optic area and in the central 3-mm optic zone 3 years postoperatively among 3-piece and 1-piece acrylic hydrophobic IOLs and 3-piece silicone IOL
This study showed that the grade of anterior capsule opacification (ACO) density was significantly greater in the 3-piece silicone IOL group than in the acrylic hydrophobic IOL groups, but there was no difference between 1-piece and 3-piece acrylic hydrophobic IOL models
Summary
Posterior capsule opacification (PCO) or secondary cataract is a major long-term complication of successful cataract surgery starting from the beginning of extra capsule cataract extraction with intraocular lens (IOL) implantation Cataract surgery technique and IOL design have undergone the significant changes. The development of modern foldable IOLs with square-edged optics has greatly reduced the incidence of PCO following cataract surgery. PCO is still the most frequent long-term complication of cataract surgery and is the most common cause of nonrefractive decreased postoperative vision [2, 3]. PCO is the result of proliferation, growth, migration, and transdifferentiation of residual lens epithelial cells (LECs) in the capsule bag after cataract surgery. The pathogenesis of PCO is multifactorial; Many techniques have been advocated to prevent PCO including intraocular lens material and design [5,6,7], surgical techniques [8], and therapeutic agents [9]
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